Survey identifies ways to improve midlife care for perimenopausal women

Key takeaways:

• Almost half of respondents to a survey about perimenopause care reported negative health care interactions.
• Eighteen percent of respondents reported positive or satisfying health care interactions.

Women who sought health care for bothersome perimenopausal symptoms reported both positive and negative experiences in interactions with providers, according to results of the Women Living Better survey.

“We are not doing that well recognizing, validating, normalizing and, if necessary, treating women’s experiences of perimenopause. There are ways that we as providers don’t realize we are dismissing concerns and making our patients feel unsupported and unsatisfied with care,” Marcie K. Richardson, MD, FACOG, director of the Atrius Health Menopause Consultation Service and assistant clinical professor at Harvard Medical School, told Healio. “This research underscores the ways in which we can leave our patients feeling heard and supported. Amid the time-pressured health care visit there are things we can do to make patients feel better cared for and enhance our relationships with them.”

Richardson and colleagues administered the Women Living Better survey, a questionnaire about 61 symptoms often associated with the menopause transition, to 1,024 women who consulted a health care professional about bothersome symptoms. Overall, 964 women (median age, 47 years; 85% white) responded to the open-ended survey question, “how did that go?” to evaluate and identify themes.

Of respondents, 81% had a college degree or more, 87% were employed at least part time, 67% had daily responsibilities related to children or other dependents and 85% were in a committed relationship. Forty-nine percent of respondents reported negative or dissatisfying experiences with health care interactions and 18% reported positive or satisfying experiences.

Researchers identified codes that reflected positive health care interactions and grouped them into the following themes that suggested satisfaction with health care interactions:

• validating experiences;
• having matching explanatory models;
• being supported by a team;
• engaging in shared decision-making; and
• having symptoms addressed.

In addition, there were also 13 codes that reflected negative health care interactions, which researchers grouped into the following themes that suggested dissatisfaction:

• invalidating experiences;
• mismatched expectations between care recipients and health care professionals;
• barriers to treatment; and
• not feeling helped.

“Research focused on the earliest part of perimenopause — sometimes called the ‘late reproductive stage’ before noticeable cycle changes — is needed so that we as health care professionals can give our patients anticipatory guidance before they start to notice changes associated with the path to menopause,” Richardson said. “Additionally, we need to better understand the relationship between what is happening physiologically and hormonally, which will better help address symptoms when they arise.”